Monday, March 30, 2015

The New Definition of Telemedicine

Buoyed by its pilot project’s success, UCLA’s Center for Inflammatory Bowel Diseases plans to expand its testing of a telemedicine system based on Apple’s iPad. The app allows doctors, nurses, and patients to communicate and track symptoms and care in an ongoing dialogue.

The latest generation of physicians is driving this type of technology—younger doctors tend to prefer wireless devices over older forms of communication. According to the American Telemedicine Association, some 10 million patients today are already benefiting from such technology—a 10-fold increase over the previous year alone!

The broadest understanding of “telemedicine” includes the growing use of patient portals that allow patients to access to their medical records and communicate more directly with doctors and nurses. Effective use can measurably reduce unnecessary patient visits.

Sharing data, including complex diagnostic images (x-rays, MRIs, electrocardiograms, and more), speeds up consults and expands the team providing care for patients. In fact, diagnostic consulting is moving to the next level: New York’s Sloan-Kettering Cancer Center has already started using the already-famous artificial-intelligence capabilities of IBM’s Watson megacomputer to help diagnose and treat cancer.

Santa Monica’s (California) Saint John’s Health Center has started a pilot program that will allow doctors to obtain genomic analyses of cancers in minutes—as opposed to the currently required eight weeks.

Telemedicine’s rapid growth is almost impossible to track. According to Body Computing Center’s founder, Dr. Leslie Saxon, app stores now offer more than 40,000 medical apps, and that does not include the 150,000 consumer-level healthcare apps available already.

We anticipate that the term “telemedicine” just might fall into disuse in the near future. What we call telemedicine today will eventually be so commonplace we’ll hardly give it a second thought. For example, consider the lowly telephone: perhaps the oldest instrument of telemedicine in the physician’s toolbox. But when reminded of that fact, most people respond nonchalantly, “Yeah, I guess it is a telemedicine channel!”

Email is close on the telephone’s heels. More and more physicians have overcome their fears about connecting with patients. Instead of an intrusive, unmanageable bother, they recognize email as an effective way to communicate on non-emergent topics. Can text-messaging or other real-time communication via iPads, Androids, and the like be far behind?

Remote viewing of digital medical images is generally taken for granted in most health systems today. And with the growing popularity of robotic surgery systems (like da Vinci), how long will it be until the surgeon at the controls will routinely drive it from a remote location?

Government agencies and medical schools are working hard to avert the predicted catastrophic physician shortage just over the horizon. And a few early indicators have prompted a few optimistic comments. But whether the shortage is catastrophic or “apostrophic” (that is, just an interruption in the routine), a shortage is coming. And the shortage will, as always, vary greatly by geographic region. Therefore, the new physician extenders will be more than nurse practitioners and physician assistants. They will include audio, video, and perhaps robots.

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